University of Houston, Houston, Texas, USA.
Trauma and Stress Studies Center, Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA.
J Dual Diagn. 2023 Oct-Dec;19(4):209-220. doi: 10.1080/15504263.2023.2260324. Epub 2023 Nov 1.
Heightened rates of posttraumatic stress disorder (PTSD) symptoms and alcohol use have been documented among firefighters. Emotion regulation difficulties (ERD) are clinically relevant to both PTSD and alcohol use. Few studies have examined the role of ERD in the association of PTSD symptoms with alcohol use severity and alcohol use motives among firefighters. Thus, the present investigation examined the indirect effect of PTSD symptom severity on alcohol use severity and alcohol use motives through ERD.
The sample was comprised of 685 firefighters (age = 38.65, = 8.57, 93.6% male) recruited from an urban fire department in the southern U.S. to complete an online survey. Indirect effects were calculated using 10,000 bootstrapped samples. Effects were examined after accounting for years of fire service, occupational stress, trauma load ( number of traumatic event types experienced); in models evaluating alcohol use motives as outcomes, other alcohol use motives ( alternate motives subscales) were included as additional covariates.
First, ERD explained the association of PTSD symptom severity with alcohol use coping motives (β = .01, SE = .003, 95% CI [.004-.01]). Furthermore, ERD did not significantly account for the association of PTSD symptom severity with alcohol use severity (β = .02, SE = .01, 95% CI [-.004-.04]), alcohol use enhancement motives (β = -.003, SE = .002, 95%CI [-.007-.000]), alcohol use social motives (β = .004, SE = .002, 95% CI [-.000-.01]), or alcohol use conformity motives (β = -.002, SE = .002, 95% CI [-.006-.02]).
Results demonstrated that, among firefighters, PTSD symptom severity is positively related to alcohol use coping motives through heightened ERD. Clinical implications and future directions are discussed.
有研究记录表明,创伤后应激障碍(PTSD)症状和酒精使用在消防员中发生率较高。情绪调节困难(ERD)与 PTSD 和酒精使用均相关。很少有研究调查 ERD 在 PTSD 症状与酒精使用严重程度和消防员酒精使用动机之间的相关性中的作用。因此,本研究通过 ERD 检验了 PTSD 症状严重程度对酒精使用严重程度和酒精使用动机的间接影响。
该样本由美国南部一个城市消防部门招募的 685 名消防员(年龄=38.65,=8.57,93.6%为男性)组成,他们完成了一项在线调查。使用 10000 个自举样本计算间接效应。在考虑到消防服务年限、职业压力、创伤负荷(经历的创伤事件类型数量)后,在评估酒精使用动机作为结果的模型中,将其他酒精使用动机(替代动机子量表)作为额外的协变量纳入模型,对效应进行了检验。
首先,ERD 解释了 PTSD 症状严重程度与酒精使用应对动机之间的关联(β=0.01,SE=0.003,95%CI[0.004-0.01])。此外,ERD 并未显著解释 PTSD 症状严重程度与酒精使用严重程度(β=0.02,SE=0.01,95%CI[-0.004-0.04])、酒精使用增强动机(β=-0.003,SE=0.002,95%CI[-0.007-0.000])、酒精使用社交动机(β=0.004,SE=0.002,95%CI[-0.000-0.01])或酒精使用从众动机(β=-0.002,SE=0.002,95%CI[-0.006-0.02])之间的关联。
结果表明,在消防员中,PTSD 症状严重程度通过增强的 ERD 与酒精使用应对动机呈正相关。讨论了临床意义和未来方向。